(106) Budget impact analysis of tralokinumab-ldrm for moderate-to-severe atopic dermatitis in the United States

Background: : Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by intense itching, redness, dry skin and recurring eczematous lesions. Treatment options include topical therapies (e.g., corticosteroids) and systemic treatments (e.g. biologics and JAK inhibitors). Tralokinumab is indicated for the treatment of moderate-to-severe AD in adult and adolescent patients whose disease is not adequately controlled with topical therapies, or when those therapies are not advisable.

Objective: : Evaluate the budget impact of tralokinumab in a hypothetical US commercial health plan with 1 million (M) members.

Methods: : Budgetary impact of tralokinumab was estimated by comparing the expected 3-year differences in costs of systemic therapy in adult and adolescent patients with moderate-to-severe AD across two scenarios: Including Tralokinumab and No Tralokinumab. Other available treatments included dupilumab, abrocitinib, upadacitinib, lebrikizumab and nemolizumab. Patients could initiate systemic therapy with any treatment or switch from dupilumab to an alternative treatment option. Adults receiving tralokinumab, and adults or adolescents receiving lebrikizumab or nemolizumab who achieved clear, or almost clear skin, could transition to a less frequent dosing schedule (e.g., Q2W to Q4W), leading to fewer doses and lower overall treatment costs. Market shares for treatments were informed by forecasting data and treatment costs were based on 2025 wholesale acquisition costs. Dosing and administration of treatments aligned with FDA prescribing information.

Results: : Of the 1M plan members, 412, 518 and 652 are estimated to receive systemic treatment in years 1-3, respectively. Total costs without tralokinumab in years 1-3 total $21.0M, $27.7M and $35.9M, respectively. Comparable costs with tralokinumab total $20.6M (∆-0.5M), $26.6M (∆-1.1M) and $34.1M (∆-1.8M). This results in an estimated cumulative cost saving of $3.4M (adults = $2.3M; adolescents = $1.1M) by year 3. Over 3 years, the cumulative cost savings per member and per member per month totaled $3.4 and $0.09, respectively. These results are largely driven by competitive skin clearance rates, low monthly treatment costs of tralokinumab vs other treatments and the option to transition from tralokinumab Q2W to Q4W dosing among adults.

Conclusions: : Use of tralokinumab in patients with moderate-to-severe AD as an alternative treatment option to dupilumab, abrocitinib, upadacitinib, lebrikizumab and nemolizumab, could result in significant cost savings for US health plans.

Sponsorship:: LEO Pharma, Inc.